MEDICARE: CARA BRIANNE ENGEL RBT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT-24-322790	GA

General Provider Information

NPI Number	:	1568209385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARA BRIANNE ENGEL RBT

Provider Business Mailing Address
First Line	:	264 BIG BUCK TRL
Second Line	:
City	:	JACKSON
State	:	GA
Zip	:	30233-6628
Country	:	US
Telephone Number	:	470-261-5053
Fax Number	:

Provider Business Practice Location Address
First Line	:	264 BIG BUCK TRL
Second Line	:
City	:	JACKSON
State	:	GA
Zip	:	30233-6628
Country	:	US
Telephone Number	:	470-261-5053
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2024
Last Update Date	:	07/09/2024

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Directions to “ CARA BRIANNE ENGEL RBT” Practice Location

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